Hailey Tran
A ventilator is a machine that supports lung function and helps a person breathe or breathes for them when they cannot breathe properly on their own. Ventilators are typically used in a hospital's intensive care unit (ICU) and are connected to a red electrical outlet, which is linked to a backup generator in case of a power outage. They are often used during surgery when a patient is under general anaesthesia, or to support patients with severe illnesses or injuries that affect their breathing. While on a ventilator, patients are monitored and provided with additional treatments and medications.
| Characteristics | Values |
|---|---|
| Purpose | Helps patients breathe or breathes for them when they can't breathe on their own. |
| Use | Patients are put on ventilators during surgery, while recovering from surgery, or when they are very sick. |
| Function | Ventilators provide oxygen to the lungs and help remove carbon dioxide from the lungs. They provide pressure to keep the alveoli from collapsing. |
| Settings | Providers can adjust the settings on the machine to meet the specific needs of the patient. |
| Intubation | Intubation and mechanical ventilation are not the same, but they often happen together. Intubation involves putting a tube down the patient's throat into their trachea. |
| Non-invasive ventilation | A face mask can be used to connect the patient to the ventilator, without the need for intubation. |
| Positive pressure ventilation | Modern mechanical ventilators use positive pressure to push air into the lungs. This can be invasive or non-invasive. |
| Additional procedures | While on a ventilator, providers will perform additional procedures such as providing medications and nutrition, bronchoscopy, and monitoring the patient's vital signs and lung function. |
| Risks | The use of a ventilator carries risks such as bacterial infections, lung damage, collapsed lung, and changes in heart function and blood flow. |
| Power source | In the hospital, ventilators are plugged into a red electrical outlet, which is connected to a backup generator in case of power loss. |
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What You'll Learn
How ventilators work
A ventilator is a machine that helps a patient breathe or breathes for them when they can't breathe properly or breathe on their own at all. This is known as respiratory failure, a life-threatening emergency. Ventilators are typically used in a hospital's intensive care unit (ICU), but can also be used in rehabilitation facilities or at home.
The first step in putting a patient on a ventilator is general anaesthesia. Then, a medical professional places a tube, called an endotracheal (ET) tube, into the mouth or nose and guides it into the windpipe or trachea. This process is called intubation. The tube is connected to an external machine that blows air and oxygen into the lungs. The machine can help with all or just some of the breathing, depending on the patient’s condition.
The ventilator uses positive pressure to force air into the lungs. It typically blows air in for one second, then pauses for roughly three seconds to allow the patient to exhale, repeating for as long as the machine is in use. The ventilator can also help hold the lungs open so that the air sacs do not collapse. While a patient is on a ventilator, doctors will monitor their heart and respiratory rates, blood pressure, and oxygen saturation. Other tests, such as X-rays and blood draws, may be done to measure oxygen and carbon dioxide levels.
Mechanical ventilators are carefully designed so that no single point of failure can endanger the patient. They may have manual backup mechanisms to enable hand-driven respiration in the absence of power. They may also have safety valves, which open to the atmosphere to allow for spontaneous breathing if power is lost. Some systems are also equipped with compressed-gas tanks, air compressors, or backup batteries to provide ventilation in case of power failure.
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Who needs a ventilator
A ventilator is a machine that supports or takes over a patient's breathing when they are unable to do so on their own. Ventilators are typically used in a hospital's intensive care unit (ICU), but patients who require long-term ventilation may be moved to a different part of the hospital, a rehabilitation facility, or their home.
Ventilators are used in emergency situations when a patient is experiencing respiratory failure. Respiratory failure can be caused by a variety of conditions and injuries, including:
- Acute respiratory distress syndrome (ARDS), which can be caused by COVID-19 or other respiratory illnesses.
- Traumatic brain injury.
- Anaphylaxis.
- Chronic obstructive pulmonary disease (COPD).
- Spinal cord injuries.
- Polio.
- Amyotrophic lateral sclerosis (ALS).
- Myasthenia gravis.
Ventilators are also commonly used during and after surgery, particularly when patients are under general anaesthesia. Anaesthesia can affect a patient's normal breathing, so a ventilator may be used to support their breathing until the effects of the anaesthesia wear off. In some cases, patients may need a ventilator for hours or longer after surgery, especially following very complicated procedures.
The length of time a patient needs to be on a ventilator depends on the underlying reason for its use. In general, patients are kept on a ventilator for as short a time as possible, and providers will regularly test a patient's ability to breathe unassisted.
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What to expect while on a ventilator
A ventilator is a machine that supports lung function and helps a person breathe or breathes for them when they can't breathe properly on their own. This could be during surgery, or when a person is very sick and their lungs aren't working properly. Ventilators are therefore a form of life support that can stabilise a person while they recover from an injury, illness or surgery.
Being placed on a ventilator is known as intubation. This procedure is typically done under sedation and involves a healthcare provider, often an anaesthesiologist, inserting a tube down the patient's throat and into their airway (trachea). The tube is then connected to the ventilator. Sometimes, a face mask is used to connect the patient to the ventilator, and intubation is not necessary.
While on a ventilator, a patient will be in an intensive care unit (ICU) and will be closely monitored by a dedicated healthcare team. This team can include doctors, nurses, critical care specialists and respiratory therapists. The team will monitor vital signs such as blood pressure, heart rate, respiratory rate and oxygen levels. They will also perform additional procedures to treat the patient or prevent complications, including providing medication and nutrition.
Being on a ventilator limits a patient's movement and they will likely have to remain in bed. The doctor may also have the patient lie on their stomach instead of their back to help the air and blood flow more evenly to the lungs. Lung imaging tests, blood tests, chest X-rays and suctioning of the breathing tube are also common procedures that occur while a patient is on a ventilator.
What to expect after being on a ventilator:
Once a patient can breathe on their own, they will be disconnected from the ventilator. They may cough while the breathing tube is being removed and may experience a sore throat and hoarse voice for a short time afterward.
Time spent on a ventilator can have lasting effects on a person's mind and body. It may take a week for every day spent on a ventilator to feel back to normal, and patients will likely need assistance for weeks to months after leaving the hospital. Post-intensive care syndrome can include physical weakness and cognitive dysfunction, sometimes called brain fog, which can cause trouble with thinking, memory and reasoning. There is also a high rate of PTSD in patients and their caregivers, as well as anxiety and depression.
Rehabilitation programs can help patients manage symptoms, bolster strength and foster emotional well-being as they navigate life post-ventilator.
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Risks and side effects
While a ventilator can be life-saving and an important part of treatment support, it also has several risks and side effects. Firstly, being placed on a ventilator can increase the risk of infection, such as pneumonia, due to the breathing tube making it difficult to cough and clear airways of germs. This can be a significant concern for those who are already very ill, as pneumonia can complicate the treatment of other conditions. Additionally, the ventilator tube can introduce bacteria into the lungs, causing infections.
Another risk associated with ventilator use is lung damage. The pressure from the ventilator can lead to overinflation and subsequent collapse of the lung (pneumothorax), resulting in decreased lung compliance and an increased risk of barotrauma. Lung damage is especially prevalent in premature infants, who may experience long-term effects such as lung infections later in life. Furthermore, there is a risk of fluid accumulation in the air sacs inside the lungs, known as pulmonary edema, which can further compromise respiratory function.
The use of a ventilator can also lead to physical weakness and a weak diaphragm, causing delays in weaning off the machine. Patients on ventilators may experience prolonged bed rest or wheelchair use, increasing the risk of blood clots, skin breakdown, and bedsores. Additionally, being on a ventilator can affect heart function, leading to decreased blood pressure or increased heart rate, resulting in reduced oxygen perfusion to the body.
The psychological effects of being on a ventilator can also be significant. Patients may experience delirium, drowsiness, confusion, and general physical weakness. The heavy sedation required during ventilation can have long-term mental health effects, including symptoms of post-intensive care syndrome (PICS), such as brain fog, poor mood, anxiety, and depression. Patients may also experience post-traumatic stress disorder (PTSD) and unwanted memories of their ICU stay. The longer the duration of ventilator use, the longer the expected recovery time, and patients may require assistance with daily activities for weeks to months after hospital discharge.
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Post-ICU syndrome
A ventilator is a machine that supports lung function and helps a person breathe or breathes for them when they are unable to do so on their own. Ventilators can be lifesaving, especially during surgeries when a patient is under general anaesthesia, or when a person is very sick.
Post-Intensive Care Syndrome (PICS) is a collection of symptoms that linger after a patient is discharged from the Intensive Care Unit (ICU). PICS can cause new or worsening symptoms that affect a patient emotionally, mentally, and physically. The ICU can be a stressful environment, and the use of life-sustaining equipment like ventilators can be a cause of stress.
PICS is not a medical diagnosis but a concept to improve awareness of post-ICU impairments. It was created to raise awareness among clinicians, patients, families, and the general public, increase screening for specific impairments occurring after critical illness, and facilitate research.
The symptoms of PICS vary across individuals, with some people experiencing no symptoms at all. Physical impairment is present in 25-80% of adult ICU survivors, with cognitive dysfunction occurring in up to 80% of patients. Psychiatric sequelae, including anxiety, depression, and post-traumatic stress disorder (PTSD), are also prevalent among ICU survivors and their family members.
PICS-family (PICS-F) refers to the adverse mental health outcomes experienced by family members and close friends who witness the stress and trauma of the ICU experience. Sleep deprivation, anxiety, and depression are common symptoms of PICS-F.
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Frequently asked questions
A vent, or ventilator, is a machine that helps patients breathe or breathes for them when they can't breathe properly on their own.
There are many reasons why someone might need to be put on a vent. This includes during surgery, as some anaesthesia drugs can make it difficult to breathe, or after surgery, especially if it was a complicated procedure. Patients with severe COVID-19 symptoms may also need to be put on a vent. Other reasons include brain and spinal cord injuries, lung disorders, and sleep disorders.
A vent works by pushing air into the lungs. The air is pushed in until it reaches a pre-set volume or pressure. Once the lungs are full, the vent stops pushing air into the lungs, and the air then passively leaves the lungs.
There are several risks associated with being put on a vent. The tube in the patient's airways can bring bacteria into the lungs, causing infections such as pneumonia. The pressure from the ventilator can also damage the lungs, and in some cases, cause a collapsed lung. Being on a vent can also affect how the heart works, decreasing blood pressure or raising the heart rate.
